Hair follicles (the tiny pouches from which
hairs grow) can become inflamed, especially on the face, chest, and back.
This inflammation is called acne. Acne affects many
individuals, especially in the teen years, but can last well into adulthood.
Acne forms when the hair follicle produces excess oil, when the follicles
are irritated (often from extra dead skin cells within the follicle), and
when plugging of the pore (opening of the follicle)
leads to increased bacteria in the follicle. Many treatments are available
for acne and some may be used together. Dermatologists (doctors
with specialized training in disorders of the skin) may offer advanced treatments
to persons who have severe forms of acne or who have developed scars from
their acne. The August 11, 2004, issue of JAMA includes
an article about treatment of acne.
Mild acne—this includes whiteheads (closed
clogged pores) and blackheads (clogged pores that
are open at the skin surface).
Moderate or severe inflammatory acne includes whiteheads and blackheads
plus papules (reddened areas that are raised above
the surface of the skin) and areas of pustules (pimples—small
bumps on the skin that contain pus).
Nodular acne—nodules are deeply
embedded solid, often painful lesions. They may develop additional infection
and may lead to scarring if not treated.
Hormonal changes associated with puberty, menstruation, or menopause
Picking at or squeezing acne lesions
Friction, rubbing, or pressure (from tight clothing, sports gear,
or harsh scrubbing of the skin)
Some medications (such as corticosteroids, androgenic steroids,
Acne is not caused by dirt or by eating particular foods such as chocolate. Heredity (biological family history) may play a role in
Routine hygiene should not be considered as treatment for acne. Appropriate
treatment for acne is designed to minimize inflammation and prevent scarring.
Keeping the face (or other areas affected by acne) clean is important, but
harsh scrubbing should be avoided. Gentle cleansers and warm water are recommended
for most effective removal of excess skin oils, bacteria, and dead skin cells.
Picking at acne lesions can be harmful. Greasy cosmetic products, sprays,
and other irritants should not be used because they may worsen acne.
Over-the-counter topical (applied to the skin)
treatments may include products with salicylic acid, resorcinol, benzoyl peroxide,
or lactic acid. Prescription medications to help acne may include stronger
topical medications, antibiotics, products that contain isotretinoin (for
more severe forms of acne), and oral contraceptives for women.
American Academy of Dermatology 888/462-3376 http://www.aad.org
National Institute of Arthritis and Musculoskeletal and Skin Diseases 877/22-NIAMS http://www.niams.nih.gov
To find this and previous JAMA Patient Pages, go to the Patient Page
link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish.
Sources: American Academy of Dermatology, National Institute of Arthritis
and Musculoskeletal and Skin Diseases
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate
in most instances, but they are not a substitute for medical diagnosis. For
specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied
noncommercially by physicians and other health care professionals to share
with patients. Any other print or online reproduction is subject to AMA approval.
To purchase bulk reprints, call 718/946-7424.
TOPIC: SKIN DISORDERS
Torpy JM, Lynm C, Glass RM. Acne. JAMA. 2004;292(6):764. doi:10.1001/jama.292.6.764